The Expression And Significance Of Sex Hormone-Binding Globulin In Gestational Diabetic Placenta

ObjectiveImmunohistochemical staining and immune electron method were used to examine the expression of SHBG in the normal and gestational diabetes mellitus placental tissue and change tendency.We analyze the relativity of placenta SHBG and fasting glucose,TC,TG and so on triglyceride to discusses the placenta spot the SHBG expression and the GDM relations,is the GDM pathogenesis research provides the new mentality and the way.Material and Method1.Clinical groupingImmunohistochemistry and electron microscopy specimens selected in August 2007 to 7 period in 2008 Chinese Medical University Shengjing Hospital, hospitalization of pregnant women,aged 21～43 years old with a median age of 30.71 years old no other obstetric complications and medical complications,there are the normal menstrual cycle.GDM pregnant women were given insulin therapy or diet control.Diagnostic criteria for the experimental group editor-in-chief in accordance with the music kit "Obstetrics and Gynecology" Sixth Edition.Conventional measurement of prenatal weight,height and blood pressure.2.Specimen Collection And TreatmentCesarean section or natural birth the placenta after delivery and immediately take the umbilical cord attached to the mother relatively department 1.0cm×1.0cm×1.0cm size of villi,cold saline rinse clean,dry filter paper placed after 10%neutral formaldehyde solution fixed,paraffin-embedded conventional Immunohistochemical specimens required 4um thick serial sections,immune electron microscopy specimens required 14um thick serial sections.Prenatal check the morning of 2mL fasting venous blood sent to our hospital laboratory to measure total cholesterol,triglyceride,high density lipoprotein-cholesterol,low density lipoprotein - cholesterol.Conventional measurement of fetal weight after delivery.3.Detect Indicators(1).Observes SHBG using the Envision immunityhistochemistry staining method in GDM and in the normal full-term pregnant woman placenta whether to express and the expression difference.(2).Under the immuno-electron microscope locates SHBG the expression spot.4.Result DeterminationSHBG mainly expresses in the placenta synthesis nutrient cell membrane and the cytoplasma.The immunity group result uses blind method each case random selection 5 by two viewers to have the representative high power field,occupies the similar cell number according to the masculine cell number the proportion,carries on the rank division.The result uses the semi-quantitative scoring law determination,dyes intensity and the masculine cell's percentage product takes the semi-quantitative standard.That is,according to the degree of positive staining score,0 is divided into colorless;1 is divided into yellow;2 is divided into brown;divided into 3 tan(depth and background color contrast);staining cells accounted for the percentage cell count<5%for 0 points, 6%～25%for 1 point,26%～50%for 2 points,51%～74%for 3 points,≥75%for 4 points.Scores points the respective multiplication each slice average coloration degree score and the average coloration cell percentage,scores points finally for it:0 divided into negative(-);1～4 divided into weakly positive(+);5～8 divided into moderate positive(++);9～12 are divided into strong positive(+++)。At under transmission electron microscope observation,syncytiotrophoblast cells showed high electron density of the particles were small Mission-shaped or punctate distribution in cells.Mainly located in the cell membrane and cytoplasm were observed with the results5.Statistical AnalysisSPSS13.0 application package for the analysis of the data,two sets of clinical data, relevant information apart from times of pregnancy,an analysis of production times, and the remaining samples Student's T test application of statistical methods;pregnant times,production times(was non- normal distribution),placental SHBG compared with the strength of non-parametric Mann-Whitney U test(two sets of data rank test Level) statistical methods;Spearmanrank associated with correlation analysis.P<0.05 for statistical difference Significance of study.Results1.SHBG in the GDM and the control group in both placental tissue expressed in placental syncytiotrophoblast cells in the cell membrane and cytoplasm.Electron microscopy syncytiotrophoblast cells appeared electron dense granules,was patchy or punctate distribution in cells,mainly located at the cell surface microvilli,cell membrane and cytoplasm.Blank control group,that is,the process of immunohistochemical anti-PBS in place of one group,no obvious syncytiotrophoblast cells immunoreactive electron density of the particles2.GDM placental SHBG at the positive expression rate(25/30,83.3%) was significantly lower than the control group the rate of positive expression of placental (28/30,93.3%) there was a significant difference of statistical significance(Z=-3.541,P<0.01).3.GDM Group SHBG expression in the placenta and the FBG(r_s =-0.842,P <0.01) were negatively correlated in the control group the expression of placental SHBG levels and FBG(r_s =-0.579,P<0.01) negative correlation,the two groups after the merger SHBG expression in the placenta and the FBG(r_s =-0.758,P<0.01) negative correlation.GDM group and control group the expression of placental SHBG levels and birth weight(GDM group:r_s =0.014,P=0.94;control group:r_s = -0.093, P=0.626) TC(GDM group:r_s=0.038,P=0.841;control group:r_s =0.187,P=0.323), TG(GDM group:r_s =0.144,P=0.488;control group:r_s =0.105,P=0.580) HDL-C (GDM group:r_s =0.036,P=0.849;control group:r_s=0.170,P=0.370) LDL-C (GDM group:r_s=-0.123,P=0.518;control group:r_s =0.256,P=0.172) no significant correlation.The two groups after the merger with the expression level of placental SHBG birth weight(r_s=0.101,P=0.440) TC(r_s=0.122 P=0.352) TG(r_s= -0.022,P=0.865) HDL-C(r_s =0.193,P=0.140) LDL-C(r_s=0.177,P=0.177) were not significantly related to each other.4.FBG GDM group(5.87±1.53 mmol/ L),TG(4.26±2.15mmol/ L),birth weight(3852.33±923.61g) are higher than those of FBG(4.39±0.55mmol/L),TG (3.05±1.03mmol/L),birth weight(3470.67±445.72g) there is statistically significant difference(P<0.01,P<0.01,P<0.05).GDM group of HDL-C(1.63±0.36 mmol/L),LDL-C(2.26±0.92mmol/ L) were lower than the control group,HDL-C (1.91±0.46mmol/L),LDL-C(2.87±1.00mmol/L).There were significant differences(P<0.05,P<0.05).Conclusions1.The expression of SHBG exist in Placenta,the main expression in placental syncytiotrophoblast cells' membrane and cytoplasm.Electron microscope syncytiotrophoblast cells appeared electron dense granules,was patchy or punctate distribution in cells,mainly located in syncytiotrophoblast cell surface microvilli and cell plasma membrane structure on.2.GDM Group SHBG expression of placental tissue were lower than the control group,suggesting that the expression of SHBG by the same pathological status of the impact of GDM.3.Placental site of the expression of SHBG was negatively correlated with blood glucose,prompted us:the placenta during pregnancy SHBG possible regulation of blood glucose has a certain role,but this effect diminished at GDM,thus speculate may be associated with insulin resistance during pregnancy there is a certain relationship between them.4.GDM group higherTG and HDL-C,LDL-C is lower than the control group of patients that may be associated with GDM on behalf of the high rate of lipid and lipid related metabolic disorders.